Even if your injury came as a result of your negligence, you are most likely still covered under Workers’ Compensation laws.
The job of an insurance company representative is to find a way to deny your claim or pay you only a portion of what you are entitled to.
An experienced workers’ compensation attorney can help every step of the way. Seek legal help if your claim is denied, or your coverage is suspended.
Every year, 3.9 million Americans are injured on the job or traveling for work. When this occurs, the worker is entitled to benefits under Workers’ Compensation Law. If a worker has not been able to perform his or her duty for a period of time, they may be entitled to these benefits.
There are several steps to take immediately after being injured on the job. First, the worker must make a list of witnesses that saw the accident. Second, a notice or claim should be filed with the employer stating that the injury occurred. In Pennsylvania, if a notice is not filed within 180 days, the case will be nullified and the worker will be unable to receive benefits.
Yes – but it is not recommended. Knowing workers compensation rights is important, and while it may feel like a fair settlement, often times the individuals are settling for a smaller reimbursement or not filing for all possible claims.
When a worker is injured on the job, there are multiple claims that may apply to the case. Workers compensation is an insurance payment that the injured may receive to cover their regular salary. A social security disability claim is a secondary claim that needs to be filed if the worker is unable to work for an extended period of time. A lesser-known claim is one of ‘pain and suffering’, which compensates the victim for their trials and tribulations that have made their lives difficult during the entire injury process. Pennsylvania residents may also be entitled to indemnity, or money lost during the initial time after the accident.
After filing notice, the employer will send you to their panel of doctors for an injury report. If the employer doesn’t send the injured worker to a doctor immediately, you need to visit your primary care physician for a report as soon as possible. The statute of limitations in these cases is three years from the date of notice, but seeing a doctor immediately is highly recommended, as insurance companies will often try to use any delay to deny or partially deny your claims.
Some employers don’t have workers compensation insurance or are trying to keep their claims low for the year. Other times employers do not think the employee is injured badly enough to merit workers compensation. In these cases the worker should immediately speak with an attorney. Pennsylvania law requires that all employers insure their workers and that all accidents at work are reported immediately.
IME’s are independent medical exams provided by the workers compensation insurance company. These doctors normally side with the insurance company and will try to send the worker back to their job as soon as possible. In some cases the doctor will send the worker to a new job performing ‘Light Duty’.
A light duty job is often a step towards regular employment. Doctors may send injured workers to easier to perform jobs prior to full reinstatement to lessen the cost of insurance payments. They sometimes send workers back prior to them being healthy enough to perform even light duty tasks. In these cases, the injured worker should speak with their workers compensation attorney immediately. Time is of the essence, and insurance companies can use any delay against you in court.
If the insurance company deems an individual fit to work, they must either return to work or speak with an attorney about continuing workers’ compensation insurance. The insurance companies and the employer will want to pay as little as possible and sometimes send injured workers back to their jobs too soon. In these events, speaking with an lawyer is strongly advised.
When an individual is receiving workers compensation payments, the insurance company may approach them in an effort to settle the case. This typically involves one lump sum in lieu of weekly payments. In some situations, this option is beneficial for the injured worker as it may afford them other opportunities. Those who are receiving workers compensation may also approach their insurance company about a lump sum settlement. However, it’s important to keep in mind that settlements are final and once accepted, you may lose your ability to challenge it in court. Insurance companies often prey on people who are in immediate need of cash and offer them settlements that are far lower than what should be reasonably expected. Professional help of a local state workers’ compensation lawyer is highly recommended before signing any such agreements.
Yes. It is not uncommon for insurance companies to verify the injury status of pending claims. Investigators are tasked with following the injured individual throughout the day to make sure they are as injured as they claim. Social networks are also a common source of injury related investigations. It is important that those who are injured act as they should, according to their injury, during their workers compensation cases. However, there are limits to how intrusive the investigation can be. In Pennsylvania, insurance investigators are not allowed to harass you, enter your property, or call you on the phone without your explicit permission. If any of such behavior happens to you, it is important to collect evidence, that can be presented in court at a later time.
"After my injury I couldn’t work. I had pains in my finger and I was working with my hands. It caused a lot of suffering. The insurance company told my employer I was to return at work. After consulting with an attorney and seeing an independent doctor I was able to take time off to properly heal."